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ALAMEDA UC 4-H Enrollment Fee Survey 2024/2025

Thank you for your interest in becoming a 4-H youth member or a 4-H adult volunteer in Alameda County.

This survey is only intended for

4-H program annual enrollment fee payments

for participation July 1, 2024 - June 30, 2025.

STOP

---- Before completing your enrollment payment ----

Please update and submit your household's 4-H enrollment profile on

**DO NOT** create a new profile if you have been enrolled at any time prior to July 2024.

New Members (never enrolled in 4-H)

New families will create a new household profile in the ZSuite system.

Enrollment Fee Payment Instructions
1) Use this survey to indicate your method of enrollment fee payment.

Option#1 - Online payment using this survey to pay by credit card.
Option #2 - Financial Waivers see information in payment section below.

What is the Cost?

To enroll in the 4-H program, youth pay $100., Adult Volunteers pay $30. (includes accident and illness insurance) Enrollment fees are charged annually and cover one 4-H program year (July 1 - June 30). Fees are not pro-rated for partial year enrollment.

*Volunteers made active between July 1 - June 30 of a 4-H program year are eligible to participate through December 31. All members and volunteers are required to re-enroll before December 1 of the program year to continue their participation in 4-H projects and activities after Jan 1 of the new program year.

Clubs and/or projects may collect additional fees from families or youth to cover the costs of project materials and 4-H events.

More questions?
Contact the 4-H Youth Development Program Office,

University of California Cooperative Extension, Alameda County sjweaver@ucanr.edu

✻ = Required

Payor Information

Email used in ZSuite: ✻

Family Name used in ZSuite: ✻

Primary 4-H Club Membership Information: The same "primary" club (unit) should be selected in ZSuite.

YOUTH MEMBERS ENROLLING FOR 2024-2025 PROGRAM YEAR

List all youth members you are paying enrollment fees for, first and last name

Or type "none." ✻

ADULT VOLUNTEERS ENROLLING FOR 2024-2025

4-H PROGRAM YEAR

In your household, are there adult volunteers enrolling* for the 2024-2025 program year?

*New Volunteer enrollment requires a Live Scan fingerprinting, online training, and a fee.

IF YES, PLEASE COMPLETE THE NEXT SECTION.

*Volunteer enrollment is not required for your child to participate.

Returning Adult Volunteer Requirements

NEWLY enrolling Adult Volunteer Requirements

Please list the names of any adult in your household who will complete the necessary steps linked above to serve as a 4-H Adult Volunteer for the 2024-25 program year.

Or type "none." ✻

Payments made for 4-H enrollment are non-refundable.

Payments made in error may be refundable if the 4-H office is contacted within 7 days of the payment error.

Payment Option #1

All 4-H enrollment fees are to paid in full by credit card.

Please indicate the number of youth members and

4-H Adult Volunteers you are paying for in this section.

Do not complete option #2

CHECK BOX AND CHOOSE the # OF YOUTH MEMBERS you will pay for by credit card for the 2024-2025 4-H Program year.

How many youths are you enrolling? Choose the quantity.

If no youth are enrolling from this household, do not check box.

(Annual youth enrollment is $100.00)

$100.00 Quantity:

CHECK BOX AND CHOOSE the # OF Adult Volunteers who will complete their enrollment.

RETURNING Volunteers requirements are linked here.

NEW volunteers and volunteers with a gap in service requirements are linked here.

You will pay for by credit card for the 2024-2025 4-H Program year. IF YOU DO NOT INTEND TO ENROLL AS AN ADULT VOLUNTEER, DO NOT PAY FOR ADULT ENROLLMENT FEE.

(Adult Volunteers, annual enrollment is $30. per adult)

$30.00 Quantity:

Payment Option #2

Do not complete this section if you have paid in section #1

Application for a need based youth fee waiver, or a partial youth fee waiver,

please complete ONLY option #2, A & B below.

PLEASE READ THOROUGHLY BEFORE CHOOSING THIS OPTION

UC 4-H programs are open to participants, regardless of their ability to pay. Program Enrollment fees will be waived or reduced for eligible youth determined to be eligible*. To request a "Fee Waiver" please indicate your need below. Provisions will be made by the Primary 4-H club to cover program fees for eligible youth who are unable to pay them.

The parent/guardian of an eligible youth for which a program fee waiver or reduction is requested *attests that the child(ren) included in this request is(are) eligible.

*To determine eligibility for a waiver or reduction of the program fee:

The annual household cash income is at or below $50,560.

FAQ about fee waivers

UC reserves the right to verify the above information by further reviewing the household financial status with the parent/guardian.

If you have additional circumstances you wish to have considered, please email Brenda Vales, bcvales@ucanr.edu

Need-based fee waivers are offered to youth only.

Option #2 - Part A: ONLY complete this section if you have read and agree to eligibility requirements and are applying for a partial or full need-based youth fee waiver.

Fee waivers are available for youth only. Fee waivers are subject to review and approval by the 4-H office.

I am not applying for a need-based fee waiver. I am applying for a need-based 50% youth fee waiver per youth I am applying for a need-based full fee youth waiver per youth

Option #2 - Part B: If you are applying for an *eligible youth fee waiver, please indicate the amount you will pay at this time, by credit card, in this section.

Youth member with 50% fee waiver, will pay $50.

Youth member with full fee waiver, will pay nothing at this time.

Fee waiver applicants will be contacted if any additional information is needed.

On the next screen, you will begin the process for entering your credit card information. A receipt will be emailed to you. If you have not received a receipt, please contact the 4-H office to confirm your payment was received.

If you have not entered any enrollment payments, the next page will show zero.

If you are having trouble with credit card processing, please view this Credit Card Processing Help Guide.

Activation of youth enrollments may take up to 48 hours (not including weekends & holidays).

Note: Adult 4-H Volunteer enrollments are made active when the required Volunteer Enrollment steps are completed. If you do not plan to complete the adult volunteer enrollment screening and training, DO NOT pay for adult enrollments, and DO Not add the name of an adult above.